Burns: In some parts of the globe, burns affect more people than HIV/AIDS, malaria and tuberculosis combined. It is a disaster that is dramatically more prevalent among women and school-aged children, and it is acutely tied to poverty.

The ability to use one's hands is crucial in the developing world.

The statistics are shocking. Worldwide, more school-aged children die of fires each year than of tuberculosis or malaria—diseases that garner a lot of attention. The hundreds of thousands who don’t die from their burns live with the physical and psychological scars of disfigurement and permanent disability. Interplast’s research has discovered that burns are the forgotten global health crisis.

Without immediate access to adequate burn care, their injuries are left to heal by themselves, creating scar tissue that can destroy function and movement, as well as disfigure them in ways unimaginable. Without adequate acute burn care, a burned foot, for example, might attach to the shin as the wound “heals” and the skin contracts, making it impossible to walk. By releasing contractures, Interplast surgeons restore movement and function to the afflicted areas. In developed countries where access to treatment is assured, these burn contractures are rarely seen.

Interplast has a long history of helping burn victims have a second chance at life. Today, around 40 percent of Interplast's work is related to burns. More than 2,250 surgeries were performed last year to help burn victims return to a life of productivity and hope.

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Hands: In the developing world, the ability to use one’s hands is crucial—the vast majority of the poor use their hands to eke out meager livings. Injuries and deformities to the hands severely limit an individual’s ability to contribute to society in any meaningful way. And yet, burns, accidents and congenital deformity all too often maim hands horribly. Over the past four decades, Interplast has performed thousands of surgeries to restore hand function. Through team trip surgeries, outreach center surgeries and operations that provide on-the-job medical training during visiting educator workshops, thousands of people have had their hand function restored. It is among the most important surgeries that can be offered in the developing world.

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Clefts: Cleft lips and cleft palates are among the most common congenital deformities, affecting an estimated one in 700 newborns worldwide, approximately 185,000 babies each year.

Children with cleft lips or palates are often ostracized from their communities and denied an education simply because they look or speak differently.

Children with clefts are frequently shunned and denied an education because of their appearance and speech impediments. Kids with cleft palates are often persistently malnourished and underweight because the roofs of their mouths are not closed, making breast feeding and eating difficult. Some children with cleft lips suffer nutritional problems as well because the gap in their lip makes it difficult to suck. They also suffer dental and middle ear problems.

Surgery can successfully repair cleft lip and cleft palate. However, in lots of developing countries, where adequate medical care may not be available, it is common for people never to receive corrective surgeries. Interplast has been working to repair their broken smiles for more than 40 years, providing tens of thousands of children and their parents hope for a better life.

A cleft lip is a congenital anomaly that occurs when one or both sides of the upper lip fail to fuse (unilateral or bilateral cleft lip). A cleft palate is also a congenital anomaly. It is found when of one or both sides of the roof of the mouth fail to fuse (unilateral or bilateral cleft palate). The severity of cleft lip and cleft palate can range from a slight notch in the lip to a wide cavity in the upper lip, upper gum, and/or palate, extending into the nasal cavity.

A variety of factors influence the development of cleft lip and cleft palate, which happens very early in pregnancy. Researchers continue to study the causes, but no one knows for sure why clefts happen.

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Follow-up: Performing cleft surgery when the patient is young is critical to allow for normal speech development. In the United States, a cleft lip is typically repaired when a baby is two to three months old; cleft palate is generally repaired within the first 12-18 months, or even sooner in some cases.

Interplast provides free comprehensive care following surgery that includes speech, hand and physical therapy through selected Surgical Outreach Centers and other venues, in cooperation with our international medical partners. This is a vital part of integrated medical care.

It has been said that the repair of a cleft in a child is not the end, but merely the beginning. Thanks to the success of a program developed by our partner in Nepal, Interplast is increasingly working to provide an integrated continuum of care for cleft patients through its Surgical Outreach Centers around the world. At some centers, this kind of broad-reaching care rivals that found in the United States and other developed countries, where virtually all cleft children who have palate repairs are evaluated by a multi-disciplinary panel that, at the very least, includes professionals in the fields of speech, orthodontics and pediatric dentistry.

Interplast is increasingly working to provide an integrated continuum of care for cleft, burn and hand patients.

Interplast is increasingly working to provide an integrated continuum of care for for cleft, burn and hand patients.

As part of Nepal’s successful program, Interplast’s surgical outreach director, Dr. Rai, and his team of interdisciplinary caregivers travel great lengths to remote villages in this mountainous country plagued by poverty. They hold week-long “speech camps” around the country, where they are able to deliver follow-up care consisting of speech therapy, dental hygiene, counseling and much more, to dozens of children and their families at one time. Therapists work with children individually and in groups. Nearly 3,000 children have benefited from the program—and many have already “graduated” with successfully integrated speech patterns.

Physical therapy following hand and burn surgery is also critical. For many years, hand therapists have been important members of some team trips and have conducted training workshops for local medical personnel. In Nepal, Nicaragua and at Surgical Outreach Centers in other countries, such therapists play a leading role in helping to restore function after surgery. Interplast is working to ensure that physical therapy becomes an integral part of the care following all surgeries for disabling burns.

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Safety and Quality Assurance: To ensure that our patients receive the safest and highest quality medical care—even in the compromised conditions developing countries often face—Interplast has developed rigorous quality assurance policies and protocols.

Surgery by its very nature is a high-risk proposition. Because Interplast medical volunteers and Surgical Outreach Center doctors perform surgical procedures in the developing world under a variety of geographical, environmental, physical and professional circumstances, there is a higher risk of complications.

Interplast strives to provide its patients with high-quality medical care through the efforts and talents of its medical volunteers and outreach center staff. In the last decade, a concerted effort has been made to systematically improve safety and quality of care, despite the challenges. This quality improvement (QI) program is overseen by Interplast’s chief medical officer (a plastic surgeon), its chief anesthesiologist and its quality improvement committee, comprised of medical experts from around the country. For more details, please download Interplast’s fact sheet on Safety and Quality Assurance.

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